VD Quiz 2 Chapter 3 Flashcards
Dysphonia
the absence of current organic pathology, without obvious psychogenic or neurologic etiology
A very common voice disorder.
Muscle Tension Dysphonia
What is persistent MTD a result of?
excessive laryngeal and related musculoskeletal tenstion
What is persistent MTD a result of other than excessive laryngeal and related musculoskeletal tension?
hyper functional true/or false vocal fold vibratory patterns
What needs to be considered when categorizing MTD as primary or secondary?
Based on whether organic pathologic conditions contribute to trigger the muscle tension behavior
Dysphonia in the absence of current organic pathology.
Primary MTD
Compensatory response to the primary etiology of dysphonia in the absence of current organic pathology.
Secondary MTD
Excessive, atypical or abnormal laryngeal muscle movements
Primary & Secondary MTD
Deviant body posture and misuse of neck and shoulder muscles.
Factor contributing to MTD
High stress levels
Factor contributing to MTD
Excessive voice use
Factor contributing to MTD
Persistently loud voice use
Factor contributing to MTD
Laryngopharyngeal reflux disease
Factor contributing to MTD
Vocal fold nodule
Benign laryngeal pathology resulting from MTD
Vocal fold polyp
Benign laryngeal pathology resulting from MTD
Reinke’s edema
Benign laryngeal pathology resulting from MTD
Located in the glottal margin of each fold (anterior-middle third junction)
vocal fold nodule
In its early stage it is soft/pliable, reddish
Vocal fold nodule
In its aged and chronic stage it appears hard and white.
Vocal fold nodule.
Continuous abuse of the larynx and misuse of the voice causes this pathology.
vocal fold nodule
What is compensatory muscular tension a symptom of?
vocal fold nodule
What is increased laryngeal effort a symptom of?
vocal fold nodules
What is incoordination of respiration/phonation a symptom of?
vocal fold nodules
Large vocal fold nodules may cause trouble doing what?
breathing (dyspnea)
VF cover is stiff and more massive, and vibration is aperiodic; posterior glottal chink may be observed with hourglass closure. What is this a voice symptom of?
vocal fold nodules
What is this a voice acoustic of? Breathiness and are wastage
Vocal fold nodules
What is this a voice acoustic of? Hoarse voice quality
Vocal fold nodules
What is this a voice acoustic of? Decreased Fo and pitch range.
vocal fold nodules
What is this a voice acoustic of? Decreased habitual loudness and dynamic range.
vocal fold nodules
What is this a voice acoustic of? Increased perturbation rates jitter/shimmer.
vocal fold nodules
What is this a voice acoustic of? Vocal fatigue, frequent throat clearing.
vocal fold nodules
What is this a voice acoustic of? higher than normal air flows (aerodynamic features)
vocal fold nodules
What behaviors do you want to address by having the client reduce or eliminate?
smoking
excess volume
vocal abuse at public events
singing style
What should the client increase if they have VF nodules?
hydration
How long will it take the nodule to go away?
as long as it took to develop
Localized, fluid filled sac on the vocal fold.
Vocal fold polyp
Pedunculated; attached by slim stalk
vocal fold polyp
sessile; blister adhere to mucosa
vocal fold polyp
hemorrhagic; blood filled
vocal fold polyp
Location: free margin of TVF
usually unilateral (90%) can be bilateral
Arise at same location as nodules.
vocal fold polyp
Arise on superficial lamina propria, but deeper than nodules
vocal fold poyp
pathology due to a single vocal event
vocal fold polyp
can resolve spontaneously
vocal fold polyp
Voice symptoms are similar to those of nodule.
vocal fold polyp
Voice symptom: incomplete vocal fold closure
vocal fold polyp
Voice symptom: decreased phonation time
vocal fold polyp
Voice symptom: decreases pitch
vocal fold polyp
Voice symptom: reduced dynamic range
vocal fold polyp
Surgery first and then voice treatment for what?
vocal fold polyps
what are the 4 stages of microflap surgery?
- small incision
- raise flap
- remove contents via suction
- lay flap down
What are the 2 goals of vocal fold polyp surgery?
- save as much of superficial lamina propria as possible
2. disrupt the glottal margin as little as possible
What is a goal is voice polyp therapy?
reduce secondary habits
What secondary habits should be reduced for vocal fold polyps?
overdriving
hard voice onset
secondary strain
What other habit should be reduced outside of secondary habits?
abusive
What should patients with vocal fold polyps practice?
vocal hygeine
Usually bilateral and asymmetric
Reinke’s edema
folds appear fluid filled
reinke’s edema
Extreme cases confused with polyps
reinke’s edema
in stobe, folds appear stiff
reinke’s edema
What is the cause of reinke’s edema?
hyper-function
smoking
extreme allergies
This occurs more in females.
Reinke’s edema
Voice acoustic: decreased fundamental frequency
reinke’s edema
Voice acoustic: decrease of range and extension of low end
reinke’s edema
Voice acoustic: increased perturbation; aperiodicity of voice
reinke’s edema
Voice acoustic: greater than normal flow loops
reinke’s edema
Reinke’s edema and related conditions are often responsive to what?
voice therapy
Treatment: reduce abuse
reinke’s edema
Treatment: decrease intensity
reinke’s edema
Treatment: noise in talking environmant
reinke’s edema
Treatment: decrease/stop “throat clearing”
reinke’s edema
Treatment: Limited vocal rest, 3-4 weeks
reinke’s edema
Treatment: increase hydration
reinke’s edema
Treatment: re-eval in 3-4 weeks
reinke’s edema
What is success from voice therapy highly dependent on?
eliminating the cause of the problem, such as smoking
increased tension or strain
misuse behavior
3 examples of increased tension or strain
hard glottal attack
high laryngeal position
anteroposterior laryngeal squeezing
Inappropriate pitch level
misuse behavior
3 examples of inappropriate pitch level
- persistant glottal fry
- lack of pitch variability
- puberphonia
Excessive talking
misuse behavior
ventricular phonation
misuse behavior
excessive, prolonged loudness
abusive behaviors
strained and excessive use during swelling, inflammation, or other tissue chanves
abusive behaviors
excessive coughing and throat clearing
abusive behaviors
scream or noise maker
abusive behaviors
